Category Archives: Energy balance

Conserved lean body mass? O_o

Alternative title: keto isn’t muscle-sparing if you compare it to any remotely sensible control group.

Exhibit A. Resistance training in overweight women on a ketogenic diet conserved lean body mass while reducing body fat (Jabekk et al., 2010)

The exercise intervention was resistance and progressive.  The diet was ketogenic, confirmed by urinary ketones… of note, presence of urinary ketones is a better indicator of ketosis than any information about diet (although they were advised to start at <20g carb/d).

 

 

As per usual, the LC diet was higher in protein… but that wasn’t enough to induce skeletal muscle growth, even when combined with resistance exercise… worded another way, resistance exercise and more protein prevented ketogenic diet-induced muscle loss:

 

 

Neither group was instructed to restrict energy intake, but from the above graph it’s relatively safe to assume the LC diet counteracted exercise-induced hunger.

Confirmed:

 

 

However, exercise-induced hunger isn’t conducive to fattening because the cause is exercise.  I think.

Ketones may spare muscle during starvation, but not in the context of regular people eating a ketogenic diet.  Otherwise, muscle mass would’ve increased in that study relative to the control group.  Confounded by negative energy balance?  Perhaps, but from where I’m standing, the LC diet did almost exactly what we expected: reduced food intake and induced a selective loss of fat mass.  And exercise also performed as expected: increased muscle mass.  In other words, if you want to gain muscle, you need calories, protein, and exercise.  Keto provides no advantages in this context.

 




 

Exhibit B. The effect of weight loss by ketogenic diet on the body composition, performance-related physical fitness factors, and cytokines of Taekwondo athletes (Rhyu and Cho, 2014)

Keto dieters got 33% more protein (40% vs. 30%), and still managed to lose almost twice as much lean mass as non-ketogenic dieters.

 

(figure from Suppversity)

 

The participants were physically active, and thus likely fairly insulin sensitive, so this may be why those assigned to a ketogenic diet lost less body fat…

 




 

Exhibit C. Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women (Volek et al., 2004)

And in this study on sedentary insulin resistant folk, keto still wasted muscle (NS) despite more protein and calories:

 

 

If you’ve been paying attention, this wasn’t unexpected.

Sedentary and overweight: more fat loss on keto.

Keto and sedentary: muscle loss.

Sleep well, get your circadian rhythms entrained proper — otherwise these efforts will give you a mere fraction of the benefits.

 




 

Other~

Protein + exercise works: Interactive effects of an isocaloric high-protein diet and resistance exercise on body composition, ghrelin, and metabolic and hormonal parameters in untrained young men: A randomized clinical trial (Kim et al., 2014)

Simply replacing carbs with fat, or resisting food for as long as possible after waking up and staring at your smart phone all night: doesn’t work.

#context

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Cyclical ketogenic diet and carb refeeds

Potential conclusion (pending full texts): “if you’re gonna keto, no need to carb”

I think these three abstracts are all referring to the same studies.  I haven’t seen the full texts.  My takes are in italics, after each abstract.

Exhibit A. The Effects of an Eight Week Ketogenic Diet vs. a Cyclical Ketogenic Diet on Performance and Testosterone in a Resistance Training Program (Lane, Lowery, Volek, D’Agostino, Wilson, et al., 2015)

Introduction: Our lab recently examined the effects of the ketogenic diet (KD) compared to a western diet regarding strength related performance; additionally, free and total testosterone was evaluated. Individuals on the KD saw similar adaptations in strength and similar changes testosterone. Comparisons of the KD against a cyclic (CKD) in strength, endurance, and testosterone have not been previously demonstrated in literature.

Purpose: Therefore the purpose of this study was to investigate the effects of the KD versus a CKD on performance and testosterone in resistance-trained males.

Methods: Sixteen resistance trained males participated in the study (age: 23.5 ± 3.3; weight: 187.6 ± 32.6). Participants on the KD consumed 5% carbohydrate, 25% protein, and 70% fat for 8 weeks. The CKD group applied the same macronutrient ratio to their diet Monday through Friday, while altering the ratio on weekends (50% carbohydrate, 25% protein, 25% fat). A periodized resistance training program was strictly followed 3 days per week throughout the duration of the study with high intensity interval training implemented on intermittent days 2 times per week by all participants. Participants were placed on a 500 kcal deficit derived from basal metabolic rate determined by the Mifflin St. Jeor equation. One repetition maximum (1RM) strength was assessed on deadlift, bench press, and leg press at baseline with a repeat assessment performed Week 8. Strength endurance was assessed on the leg press at baseline and re-assessed at Week 8. Free and total testosterone was evaluated at baseline and at Week 8. An ANOVA with repeated-measures was used to scrutinize the effects of KD and CKD on dependent variables assuming group (KD and CKD) and time (pre and post) as fixed factors. The significance level was set at p ? 0.05.

Results: There were no differences between groups in the performance tests or testosterone levels detected at baseline (p > 0.05). A time effect was observed for bench press and deadlift 1RM (p < 0.01). There was a trend towards a group by time interaction (p = 0.07) which favored an increase in the leg press 1RM in the KD group. There were no significant differences for leg press strength endurance in both groups. For free testosterone, there were no group or group × time interactions (p > 0.05). For total testosterone, there was a group × time interaction following the diet treatment (p < 0.02). The pairwise comparisons revealed that only the cyclic group decreased in total testosterone (10.3%, p < 0.02).

Conclusions: In regards to performance, a strict KD seems to augment positive strength related adaptations when compared to a CKD. These responses may be explained by sustained total testosterone levels seen in the KD group compared to reductions in total testosterone as a result of the fluctuations in macronutrient intake.

Practical Applications: Individuals attempting to optimize adaptations in strength performance while maintaining testosterone levels should perform a KD compared to a CKD.

My take: no difference between KD & CKD, despite testosterone declining in CKD.  This isn’t surprising because small fluctuations within the physiological range are not expected to affect these outcomes.

When protein and calories are controlled, and the #context is a 500 kcal deficit, not really sure what they were expecting.  Because of the constant deficit, insulin will be low even on the carb-up days, and those carbs are more likely to be burned off than replenish glycogen.

 

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High Meat, Low Carb During Pregnancy

The Motherwell Studies

Around 50 years ago a group of expecting mothers were asked to increase their meat intake to about a pound a day and cut out the carbs (Campbell et al., 1996). They assessed a variety of traits of the infants and again when they were all grown up.

The babies were healthy, but as adults they tended to have higher blood pressure (Shiell et al., 2001), higher cortisol response to stress especially if the diet was also low in green vegetables (Reynolds et al., 2007), and modestly worsened glucose tolerance (Reynolds et al., 2007).

 

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The BROAD Study or Meat

Is eating meat necessary?  Optimal?

THE ANSWER MAY SURPRISE YOU

Hint: it’s more important to not eat processed refined junk foods.

 

Exhibit A. The BROAD study: a randomized controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease, or diabetes (Wright et al., 2017)

Tl;dr: it worked.

 

 

The longer version: it was a low-fat vegan diet supplemented with 50 ug B12 (methylcobalamin) daily.

 

Participants were advised to eat until satiation.

We placed no restriction on total energy intake.

Participants were asked to not count calories.”

 

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What or When to Eat

Artificial light at night, crappy sleep, and skipping breakfast are major contributors to poor circadian rhythms.  Some bro’s insist WHAT you eat is infinitely more important than WHEN you eat.  I beg to differ, at least in part – nix the refined & processed foods and it doesn’t really matter if you prefer low fat or low carb (P<0.05).  Evidence: Hunger-free diet(s).

 

Exhibit A.  On the other hand, feed two people identical diets but induce circadian disruption in one and whammo – big difference in outcome.

 

 

Significantly less fat loss and more muscle loss in the circadian disrupted group.

Interindividual variability? Yes.  Statistical significance? YES.

 

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A timeline of ketoadaptation

This is how ketoadaptation works (when it works), chronologically, on physical performance (I think):

 

 

Dark grey line: the gradual increase in performance for someone training on a regular diet.

Red line: performance declines on keto initially, but is back to baseline (light blue line) by week 3.

Light grey line: as long as ketoadaptation doesn’t impair performance, similar gradual increase in performance for someone training on a regular diet.  Parallel to the dark grey line.  May even catch up to the dark grey line.  I don’t know, but probably not as per FASTER – long-term LC athletes were not superior to their LF counterparts.

 

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LCHF negates performance benefit of training. O_o

It takes about 3 weeks to become fully ketoadapted and you don’t really get more ketoadapted thereafter, at least as per max fat oxidation rates (which seems a pretty good surrogate, imo).

Important point: “Athletes who drop carbs cold turkey suddenly suck.”  And performance usually recovers by around week 3.  This has been confirmed in nearly every proper study on the subject, in a variety of contexts.

 




 

Which brings me to the latest alleged slam on keto & physical performance:

Low carbohydrate, high fat diet impairs exercise economy and negates the performance benefit of intensified training in elite race walkers (Burke et al., 2016)

 

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HANGRY! (part deux)

Effects of diet composition on postprandial energy availability during weight loss maintenance (Walsh et al., 2013)

Now, we’re getting somewhere!

3 diets (carbs 10%, 40% or 60%; protein was higher in the lowest carb group). Four weeks. CROSSOVER.

Then a test meal which approximated the diet assignment. Total “energy availability” in the blood was approximated by measuring the calories in blood glucose, free fatty acids, and ketones.

 

energy availability and metabolic rate

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These dudes ate a ton of sat fats and nothing bad happened

Study: 12 weeks, obese men, very high fat low carb (VHFLC) vs. low fat high carb (LFHC) (Veum et al., 2016) #FATFUNC

 

Pictorially:

 

 




 

It wasn’t explicitly AD LIB, but pretty close.  I say this because that is the magnitude of appetite decline we might expect when people go on The Hunger Free Diet(s), eg,

 

^^^ GOOD IDEA

 

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Ketones inhibit lipolysis

Petro just posted a brief article about acipimox & the insulin hypothesis.  Similar to insulin’s forte, acipimox inhibits lipolysis.  This leads to expansion of adipose tissue, and eventually, weight gain.

Acipimox acts on the same receptor as niacin and ketones, GPR109a.  That is, all three of those agents inhibit lipolysis.  We’ve discussed some of the implications of this on fuel partitioning HERE.

 

ketone-supp-physiology

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